Haleigh R Dutton, BCBA

Key facts

NPI

1114560596

Entity type

Individual (NPI type 1)

Primary specialty

Behavior Analyst 103K00000X

License

1-22-59252 (FL)

Practice address

80 College Blvd E
Niceville, FL 32578-1343

Phone

(850) 279-3000

NPI assigned

Oct 18, 2019

Sex

Female

Sole proprietor

Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Emerald Coast Autism Center Community/Behavioral Health Agency · Niceville, FL · NPI 1972030617
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 21, 2022.

{
    "created_epoch": "1571356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661040000000",
    "number": "1114560596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4133 KIRKPATRICK RD",
            "city": "SOUTHPORT",
            "state": "FL",
            "postal_code": "324092127",
            "telephone_number": "850-890-3721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 COLLEGE BLVD E",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325781343",
            "telephone_number": "850-279-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUTTON",
        "first_name": "HALEIGH",
        "middle_name": "R",
        "credential": "BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-18",
        "last_updated": "2022-08-21",
        "certification_date": "2022-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-22-59252",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-19-95999",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Niceville, FL · Behavior Analyst in Florida